Claims Administrator I ( STD Case Specialist )

Aquent is partnering with a leading financial services organization dedicated to making a tangible difference in the lives of individuals, families, and communities worldwide. This organization prides itself on fostering a dynamic environment where unique backgrounds and perspectives are celebrated, and every team member is empowered to reach their full potential. You'll join a team of experts eager to share knowledge, and leaders committed to inspiring your growth. This is an opportunity to contribute to a mission that brightens lives, delivering superior service and support to clients at every turn.

About the Opportunity

Step into a pivotal role as a Case Specialist, where your expertise will directly impact the well-being of clients by ensuring timely and accurate resolution of short-term disability claims. You will be at the heart of service delivery, making critical decisions that provide peace of mind and essential support during challenging times. This fast-paced and exciting environment offers the chance to work autonomously while being an integral part of a collaborative team, contributing significantly to client satisfaction and the organization's commitment to excellence. Your keen eye for detail and compassionate approach will ensure individuals receive the support they need when they need it most, truly brightening lives through your work.

What You'll Do

As a Case Specialist, you will be instrumental in delivering exceptional service and support to claimants and clients. Your daily contributions will directly influence the lives of individuals navigating challenging times, ensuring fair and accurate claim resolutions.

• Work both independently and collaboratively to deliver exceptional service to clients and claimants.
• Review claims thoroughly and make final determinations regarding benefit approval or denial.
• Authorize claim payments within established limits, leveraging appropriate guidelines.
• Evaluate duration guidelines and recommendations from clinical and vocational resources to determine the correct disposition of claims.
• Document and act on strategic assessments to ensure claims are adjudicated efficiently and accurately.
• Interpret contracts to ensure fair and consistent claims practices, adhering to all relevant laws, regulations, and procedures.
• Gather necessary supporting documentation to substantiate disability claims and communicate effectively with employers, claimants, physicians, attorneys, and other relevant parties.
• Contribute to other related duties, such as supporting claims staff or assisting with special projects, as business needs arise.

What You'll Bring

We are seeking a dedicated and analytical professional with a passion for service and a commitment to accuracy. Your skills will be vital in navigating complex claim processes and providing crucial support.

• Strong mathematical aptitude for precise calculations and claim payments.
• Excellent judgment and decision-making skills to adjudicate claims in line with policy provisions.
• Proven ability to comprehend and interpret legal and medical terminology for claim decisions.
• Exceptional organizational skills and the capacity to effectively manage multiple tasks.
• Ability to communicate effectively with internal and external contacts while handling highly confidential information.
• A strong client service focus, always seeking solutions.
• Effective analytical and problem-solving capabilities.
• Resilience and adaptability to thrive in a fast-paced and demanding environment.
• A track record of successful autonomous work alongside effective team collaboration.
• Outstanding written and verbal communication skills.
• Strong interpersonal skills.
• Demonstrated ability to meet deadlines with a high degree of accuracy and attention to detail.
• 1+ years of experience in customer service or financial services.
• Proficiency in end-user computing, including MS Office Outlook, Word, and Excel.
• A quick learner with the ability to master various computer applications.

Bonus Qualifications That Will Set You Apart

• Associate or Bachelor degree.
• Prior claim management experience.